Update Collector Policy | Collectibles Insurance Services | Collect Insure

Automatic Monthly Increase:

AddRemove

This is an optional coverage for new acquisitions and appreciation of your existing collection. Adding this coverage will apply an automatic monthly increase of 1% in coverage, up to a maximum of $1 million.

Comments:

Mailing Street:

Mailing City:

Mailing State:

Mailing ZIP Code:

Change Also Applies to the Premises Location:

YesNo

Comments:

Location Street:

Location City:

Location State:

Location ZIP Code:

Existing Policy Limit of Insurance:

Requested Policy Limit of Insurance:

Change is the result of adding or removing scheduled items:

YesNoEmpaty

If Yes, please also complete the Schedule Items form.

Comments:

Central Station Alarm:

AddRemoveEmpaty

Calls alarm company or police (location away from premises which is continually monitored)

Safe:

AddRemoveEmpaty

Weighs at least 300 lbs. empty, no wheels, with a combination, digital or key lock.

Vault:

AddRemoveEmpaty

Has 3-inch walls, no windows and metal doors.

Location Street:

Location City:

Location State:

Location ZIP Code:

Comments:

Away from Premises:

WorldwideDomestic

Coverage Amount, Including Excess Coverage:

Reason for Being Away from the Premises:

Travel Date From:

Travel Date To:

Travel From Location:

Travel To Location:

Comments:

Coverage Amount, Including Excess Coverage:

Shipment Date:

Items Shipped:

Shipping Carrier:

Shipping Method:

City & State of Origin:

City & State of Destination:

Signature Required:

YesNo

Only Signature Required shipments will be eligible for Temporary Excess Coverage.

Comments:

Add/Remove Type of Collectible:

Add Type of CollectibleRemove Type of Collectible

Type of Collectible:

Change will affect my current policy limit of insurance:

YesNo

If Yes, please also complete the Policy Limit of Insurance form.

Comments:

Please note that no coverage will be bound and no changes made on any policy without a written "Confirmation of Insurance", Binder, Endorsement or Reinstatement from Collectibles Insurance Services. Coverage cannot be assumed if you do not receive one of the aforementioned notices.

Update Collector Policy | Collectibles Insurance Services | Collect Insure

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